Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLESInformant Disagreement for Separation Anxiety Disorder
Section snippets
METHOD
Subjects were participants in the Virginia Twin Study for Adolescent Behavioral Development (VTSABD). The VTSABD is a longitudinal community-based study of 1,412 Caucasian families with 8- to 17-year-old juvenile twins (Eaves et al., 1997; Hewitt et al., 1997). Twins were eligible for the current study if the twin, mother, or father was interviewed about the twin's history of SAD at entry to the study. The eligible sample comprised 2,779 individual twins (1,280 boys and 1,499 girls).
Families
RESULTS
Child interviews identified more cases of SAD than parent interviews (Table 1). Between 30% and 50% of cases had some degree of associated impairment. The female-to-male ratio of cases was higher based on parent (especially paternal) interview. The prevalence of SAD declined in association with increasing age, but age trends were statistically significant only for cases diagnosed by the or-rule or child interview. Pubertal status was associated with SAD in girls after partitioning out the risk
DISCUSSION
SAD is a relatively common disorder based on child interview or an or-rule, but SAD is a relatively uncommon disorder based on parent (particularly paternal) interview or in association with any degree of functional impairment. Girls are more likely to be diagnosed with SAD than boys, but this sex difference is more pronounced based on parent (especially paternal) interview. The prevalence of SAD peaks in younger children, but child interviews index more age-related variation than parent
REFERENCES (29)
- et al.
The Child and Adolescent Psychiatric Assessment (CAPA)
J Am Acad Child Adolesc Psychiatry
(2000) - et al.
Aggregating data from multiple informants in child psychiatry epidemiological research
J Am Acad Child Adolesc Psychiatry
(1992) - et al.
Correspondence between adolescent report and parent report of psychiatric diagnostic data
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
Multiple informant agreement and the Anxiety Disorders Interview Schedule for parents and children
J Am Acad Child Adolesc Psychiatry
(2003) - et al.
Parent and child contributions to diagnosis of mental disorder: are both informants always necessary?
J Am Acad Child Adolesc Psychiatry
(1999) Parent-child agreement in clinical assessment of anxiety and other psychopathology: a review
J Anxiety Disord
(1991)- et al.
Reliability of the DSM-III-R childhood anxiety disorders using structured interview: interrater and parent-child agreement
J Am Acad Child Adolesc Psychiatry
(1994) - et al.
A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the Child and Adolescent Psychiatric Assessment (CAPA-C)
Psychol Med
(1995) - et al.
The Child and Adolescent Psychiatric Assessment (CAPA)
Psychol Med
(1995) The relationship of factors in parental ratings of self and each other to the behaviour of kindergarten children as rated by mothers, fathers and teachers
J Consult Psychol
(1960)
Relations of factors derived from parent interview ratings to behaviour problems of five-year-olds
Child Dev
Evaluation of the Diagnostic Interview for Children and Adolescents for use in general population samples
J Abnorm Child Psychol
The assessment of affective disorders in children and adolescents by semistructured interview. Test-retest reliability of the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present Episode version
Arch Gen Psychiatry
Interparental agreement on child behavior problems
Psychol Assess
Cited by (42)
Developmental Epidemiology of Pediatric Anxiety Disorders
2023, Child and Adolescent Psychiatric Clinics of North AmericaDemographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description
2018, Developmental Cognitive NeurosciencePredictors of parent-child agreement on child anxiety diagnoses on the ADIS-IV-C/P
2016, Psychiatry ResearchCitation Excerpt :Therefore, parents may be more disturbed by a child's symptoms than the child when externalizing behaviors are prominent. Children with externalizing behaviors such as opposition or defiance may also be unwilling to cooperate with interviewers and may intentionally provide inaccurate information (Foley et al., 2004; Storch et al., 2012). Family accommodation, or behaviors on the part of family members to reduce distress or functional impairment associated with anxiety, is highly prevalent within families of anxious youth (Lebowitz et al., 2016; Storch et al., 2013; Thompson-Hollands et al., 2014).
Major Depression in the National Comorbidity Survey–Adolescent Supplement: Prevalence, Correlates, and Treatment
2015, Journal of the American Academy of Child and Adolescent PsychiatryCitation Excerpt :Parents who completed the full SAQ provided information about MDD and dysthymic disorder, SAD, ADHD, ODD, and CD, whereas those completing the abbreviated SAQ reported only on ADHD. Because prior research has indicated that adolescents are the most accurate informants of their emotional symptoms,15-18 only adolescent reports from the CIDI were used to assess diagnostic criteria for MDD, dysthymia, anxiety disorders, and substance use disorders, whereas only parent reports were used for diagnoses of ADHD. Information from both the parent and adolescent were combined for behavior disorders and classified as positive if either informant endorsed symptoms for diagnostic criteria.15,19
Preschool anxiety disorders in pediatric primary care: Prevalence and comorbidity
2013, Journal of the American Academy of Child and Adolescent PsychiatryDSM-IV criteria for childhood separation anxiety disorder: Informant, age, and sex differences
2010, Journal of Anxiety DisordersCitation Excerpt :There are several important clinical implications that may be drawn from the present study findings. The diagnostic validity of the use of the “or-rule” (i.e., considering symptoms present even if only indicated by one informant) must be further examined due to the unclear validity of diagnoses based on this rule given the poor diagnostic agreement between parents and children (Foley et al., 2004). Based on the current findings, the “or-rule” seems more practical than a conservative “and-rule,” where diagnostic criteria are only met if reported by all informants.
This work was supported by NIMH grants MH-60324, MH-45268, MH-57761, and MH-65322 . The authors acknowledge the contribution of the Virginia Twin Study for Adolescent Behavioral Development, now part of the Mid-Atlantic Twin Registry (MATR), to ascertainment of subjects for this study. The MATR, directed by Drs. Corey and Eaves, has received support from the NIH, the Carman Trust for Scientific Research, and the WM Keck, John Templeton, and Robert Wood Johnson Foundations.